Provider Demographics
NPI:1437837044
Name:CHEVEYO LLC
Entity Type:Organization
Organization Name:CHEVEYO LLC
Other - Org Name:ASCEND RECOVERY CENTER WI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUTHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-252-9389
Mailing Address - Street 1:5716 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-3607
Mailing Address - Country:US
Mailing Address - Phone:561-252-9389
Mailing Address - Fax:
Practice Address - Street 1:1881 PRIDE TER
Practice Address - Street 2:
Practice Address - City:SUAMICO
Practice Address - State:WI
Practice Address - Zip Code:54313-8087
Practice Address - Country:US
Practice Address - Phone:833-888-2723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility